Wells Fargo throws us under the bus. Aetna Better Health / Illinois HFS throw us under the bus.

After a member of the "Care Team" (from the Office of the President) indicated by phone last Tuesday that they accepted my 2015 Grafton Township Assessment and had done an Escrow Account review and had reduced our Monthly payment by $229 which when combined with our income, should affect the Re-entry team in re-opening the case given the substantial reduction in the monthly deduction when compared to our income presented.... and he stated that some activity regarding review should commence by either close of business yesterday or sometime today, I patiently waited and called for my "Home Preservation Specialist" this afternoon at 3:30 pm before they close. She was unavailable and I was transferred to the “Re-entry Team”. I waited for that person on hold while they reviewed the documentation and after 12 minutes, I was told that the $230 per month escrow reduction was not a "change in our circumstances", so Wells Fargo cannot re-open my case and unless I have any other info that shows a change in our circumstances… the case will remain closed. I was then asked if I wanted to move forward with the alternatives left (short sale/etc.). I indicated….. nope (we will have to pay the taxes on any loss which would be being taxed on over $140,000 in losses as our home is only worth $81,000 according to our latest assessment). PLUS, we still owe over $30,000 regarding Illinois Hardest Hit (and will have to pay taxes on that also). That means even if we file bankruptcy, we are still on the hook for the taxes. Short sale? Deed in lieu of payment (and walking away)? Seriously???????

<My jaw hit the floor>

I’ve emailed Randy Hultgren (my congressman) 2 days ago with no response thus far. Social Security is estimating a minimum of 68 days to change my status to approved (that means around the beginning of the year next year….. 3 weeks after loan acceleration is supposed to happen). They only have to make a change to a code in their system, and it will go live with the benefits. I've also been told on the ebenefit government website that the VA won’t make a decision on the Dependent claim for at least another 390 days (despite the fact all they have to do is "click" approve in their systems).

It looks like no matter what we do now, our home will go into the foreclosure process. I know the VA housing department will try to hold that off, but even they can only do so much.  I have been as pro-active as I can be without going to the government offices (and demonstrating in front of them).

Folks - I am about ready to say Uncle……. I don’t want to, but everyone other than the VA housing dept. seems to be too invested in following “process” to work with us. We HAVE the income. We've run the numbers with McHenry County Credit Counseling and we are below the 31% limit of our earnings.

Our present income brings us to less than the 31% of income level we need to get approved for any modification. Apparently, the escrow reduction by $230 per mo. is not a trigger they use in that determination (even though it IS used when being reviewed). They just won't start a new one because it doesn't meet their "definition" of a "life circumstance change". A technicality that any higher up VP should be able to be empowered.... to make a decision to disregard if we truly are less than 31% of income regarding the mortgage payment (and would be able to make our adjusted monthly payment).

Another technicality (they HAVE my SSDI benefit amount in writing on SSA letterhead that should be starting in January (and is back dated 2 years), they just don't have a SSA "approval letter" that they "accept"). Another "technicality". It clearly appears they don't want us in this home (that is worth $140k less than it's principle). Maybe they need some "loss" tax ride-offs that their CFO has identified to enhance shareholder value when announcing their quarterly earnings (we are not the only ones in this boat). We are sooooooooooo close (but we might as well be a mile away)....... we just can't get the government to find it within themselves to move the case to the top of their pile/backlog and for Wells Fargo to re-open the case when they KNOW we'd qualify if it went to their underwriting department based on our present income.

Our frustration/stress level is not helping my wife’s nor my medical health and one eventually has to recognize that and say… is this worth the battle anymore?

Wells Fargo, Social Security, and the VA (not housing benefit side) are stuck in an antiquated world of process and political posturing while not resolving issues for those same Veterans, and are basically sticking up for themselves (their jobs and process). Their customers (us) lost the battle of their caring/concern long ago.

We are resigned to our fate, it looks like we'll ultimately have to move due to no reason other than a "technicality". I've never have felt more helpless/hopeless in my life. Yes, God has our backs and I know we'll land safely somewhere (and my faith preservers).... but jeez..... why is it ALWAYS the worst case scenario with us? :(

Speaking of which, Penny was "bounced out" of Aetna Better Health (the Medicaid provider we were forced to pick last open enrollment) sometime in October. We received no notice in writing. And when we call, her Customer Number doesn't come up, so they won't even talk to us. Now Penny is back with "Standard Illinois Medicaid". The thing is, that is good news as CTCA accepts "Standard Illinois Medicaid" as it is not an HMO  (which we didn't find out until July that Aetna Better Health was an HMO... there was nothing in the original documentation indicating that... and I have print outs of the documentation when Penny applied November 2014). So what happens (when she has to go into CTCA next week for a follow up Cystoscopy - her first since her bladder/kidney saving surgery last July???)...... we get a letter from Illinois HFS that Penny has to choose from 5 "Medicaid Providers" with Aetna back amongst them and they are ALL HMO. Which means CTCA will not accept any of those providers. So we are back at square one.

So, does Illinois HFS or the Illinois GetCovered website have any answers? Nope.

We are stuck not knowing what direction to go. In the interim, nobody is accepting new patients regarding Urology or Oncology. What good is Insurance if there is no place to get treatment.

Incredibly frustrating.

Obamacare (the ACA) and the coverage chaos we are presently dealing with.

So, we just got a call from CTCA. They verified Penny is back on "Traditional Medicaid" (WOOHOO...

as that means CTCA will accept that as it is NOT a "HMO/ManagedCare" insurance). However, that means Penny is no longer with Aetna Better health. HUH????? I don't recall that being part of the ACA Open Enrollment decision last year (for Aetna to "opt out" of covering Penny before the end of the year). What this means, is that CTCA will now again accept Penny for future care (including the Cystoscopy that is due this month). But wait, now we find Penny's account is on a "Financial Hold".

So, I went over the latest statements from CTCA and we've noticed that we still have over $52,000 in billing that Aetna has not acted on yet (from June, care that they authorized).

                                               

So we are now completely befuddled as Aetna won't answer our questions.... nor will Medicaid (as Aetna was still the provider at that time). Also, just how the heck do we handle Penny's Open Enrollment this year (as she is given zero options in the Federal Marketplace after being punted there from the Illinois GetCovered website). Its a good thing I have a 3 ringed binder from last years enrollment (where I printed everything off) so I have proof nobody on our end screwed up.... and I also have this years printed out.

Listen folks, I am on top of this (I used to work for MetLife and have a general understanding of insurance in and outs) and even I am having trouble traversing this anarchy/chaos.... can you imagine what other people are going through trying to figure all of this out?

How does what is called an Insurance Plan through a legitimate Insurance Company (Aetna, one of FIVE plans handling Medicaid this year via the MarketPlace) all of a sudden stop paying bills, no longer cover a person and punt that person back to the original state plan.... and not put ANYTHING in writing to notify us of this.

I am wondering if this is happening to more people in Illinois than just us (and I wonder if former Representative Joe Walsh should inquire with those people "in the know" that he knows if this is indeed happening). If it is, why isn't the news media all over this issue? I am punting an email to him as we speak to see if he knows anything about this and if not, if he can find out if this is an issue many in Illinois are dealing with.

Uff and Da. =(

SSDI Approval - Wells Fargo generic loan modification denial - and the future.

 I was approved for SSDI benefits 2 days ago (during my hearing). Almost 3 years after my initial request for benefits.

It took me almost 3 years to get approval for VA and SSDI benefits (and I had to get a non-attorney representative familiar with both the VA and with SSA to represent me using the governmental inside info they had accumulated over the years they worked at the VA and at SSA in order to have my case presented in such a way that was "pleased" those who were the decider's). heaven forbid one should say "Yes Ma'am, Yes Sir, or Yes Your Honor more than once (apparently, it is rude to use ma'am,sir.your honor more than once when answering their questions). The information was there the entire 3 years, and yet it wasn't the medical information that won the day, it was how it was categorized and put together in a format that is only understood by insiders (criteria only known by those who are IN the system). VSO's sincerely expect us to understand just how the VA works and genuinely seem perplexed when you have the homer look on you after they try explaining what is essentially, unexplainable to the average lay person.

My VA rep will receive 20% of my benefits (around $4,500) and he did a great job earning it (he knew exactly how to adjust my claim to "fit" VA criteria). My SSDI rep will receive $6,000 of my SSDI benefits (well earned also, as he knew the people in the hearing office, he knew their tendencies, and he knew what would be accepted or not accepted (rightly or wrongly, it depends on the judge and what they expect). And I had to negotiate with the ALJ regarding the 5 month time period prior to my 50th birthday by agreeing to amend my claim to a new onset date (as recommended to me by my representative after he spoke with the judge prior to my going into the hearing room). So in a moment's time, I had to decide whether it was worth fighting for the $10,500 in benefits I would lose if amending my claim by 5 months to fit the judge's decision made easier by my turning 50 on basically a technicality of disability definition (in order to help my family by getting approved now instead of denied and having to prove the 5 months also as the judge was not willing to go back all 5 months).  That is the fastest I have lost $10,500 in my entire life. And here is the thing......  if I didn't have this particular judge, I might not even have been awarded a benefit (many judges have their own criteria, despite the fact that they shouldn't).

So.... that is $21,000 in benefits lost to my family and I. The reason why I had representatives is due to a lesson learned in our family.

I felt I had no choice but to get a representative from the beginning, because my wife went in front of a ALJ in 2008 without representation and did what all people do...... explained what she thought was needed to be presented to the ALJ (who then took her attempt at trying to do things as evidence of ability and who called her a malingerer in the Denial letter... yes, we have that in black and white). Despite the evidence of serious limitations including dysfunction of her left arm after she was shot (and she went back to work trying to do a job, but ultimately could not due to her limitations). She tried very hard to keep working. And she was called a malingerer? I knew right away I had to fight for the benefits and use a representative to make that happen.

As far as I am concerned, one should not be allowed to go for any government benefit without a representative because the process is stacked against us..... all of us claimants. Its no different than going to criminal court as far as I am concerned. My wife's claim was closed in 2008 due to the lack of pro-activeness on her Long Term Carrier's part and because my wife thought she was getting a representative who were instead of representing her.... were "keeping an eye on her claim" for her LTD carrier (so her appeal was not filed in time). I had to get it re-opened by providing medical information not present for the ALJ hearing in order to get her case re-opened (it is called, Res Judicata) and she started at the back of the line in 2013. Officially, she has been fighting for SSDI benefits for TEN YEARS now!!!!!!!!!

Now.... I am very grateful for the benefits I am now eligible for (we are very blessed) as it will help us eventually stabilize our lives. However, it took far too long to get them (and it has financially destroyed our family in the process... to the point we are barely hanging onto our home and also having had a vehicle repossessed... the first time in our lives). We STILL have a lot of bills to pay, but we are still limited to what we can pay off because we are still under the microscope regarding our mortgage (and we are advised to not spend anything that is considered "unnecessary" - otherwise, we will harm our effort at a loan modification to save our ability to remain in the home). Speaking of which, even the VA can't understand why Wells Fargo didn't take into account the VA benefits I was just awarded (they didn't even wait the 30 days for them to get proof of my benefit in a bank statement, they just denied us AGAIN and with no options to appeal. We now have all of the information they need plus the income for them to make a re-modification, and they don't care because a government VA benefit award letter isn't "enough proof" of income (one just can't make this stuff up). So after 3 years of fighting this (and using Illinois Hardest Hit to stay in our home), Wells Fargo's underwriter can't read governmental documentation showing a direct deposit to my bank showing the deposit of my VA benefits (theyn need to see TWO monthly bank statements showing the deposit). Auuuuugggghhhhhh!!!!!!!!

So, Penny is scheduled for yet another SSDI hearing (in 10 years) coming next April/May (because the ALJ dropped the ball in 2008 and didn't take into account information from 2001-2004 that permanently limited her ability to use her arm/ and both hands as a result of her neurological damage from being shot). I finally had it entered into their record, they just aren't looking at it when deciding on eligibility (before it ended in 2007). Her file is so thick, no attorney wants to touch it now (even Allsup dropped her file as they thought it was unwinnable), so we are trying to find someone willing to take on this burden with no success thus far. Penny is the only person I know who still has Long Term Disability benefits past 2 years of disability that doesn't have Social Security Disability (mainly due to the lack of a representative at her hearing). We learned our lesson and took a $21,000 hit on my benefits to ensure that didn't happen again. A very expensive lesson.

And stunningly, I am one of the lucky/blessed ones. There are many who lack the resources and support we've had for the past 3 years (most disabled veterans or disabled civilians lose everything in their effort to be awarded a benefit when it is due under Federal law... even though the evidence IS there right in front of the decision makers).

Here is the rub. It can get worse.

Hillary Clinton indicates there isn't a systemic problem at the VA nor with Social Security. As far as I am concerned, anybody who votes for Hillary Clinton who hasn't reviewed the facts on her time in power truly has a screw loose and doesn't see all of the mistakes she has made (that harm people), or how elitist she truly is, how harmful/hateful she is to her own people (including security staff AND Military staff there supporting her regarding the doing of her job). People have DIED as a result of her actions while in power. I cannot imagine a more unfit individual for the top job in the United States. And I pity both veterans AND those seeking Social Security should she come into power again (her blinders and excuses know no bounds). I truly would rather see Bernie Sanders or Donald Trump get the job first before that horrible human being presently smirking her way through hearings at the moment. In order to get qualified for benefits, I first had to give others $21,000 of those benefits (that I EARNED both in service to my country and as a very hard working individual for over 35 years).

Just imagine how much that would have helped my family. No problems with the VA and SSA system? Hillary - you are FIRED.

It has been a LONG time since I last posted..... I have much to share (mostly joyful news also). Penny's cancer is in remission.... and I now have VA benefits. =)

Well, as one can tell..... I haven't spoken on this blog for a while. The reasons are many, but the major reason was because I had received feedback that I might want to ease up posting for a while since it seemed I had nothing to report but bad news (plus my depression / anxiety was to the point I was being hospitalized for it and other things). Sometimes, when things are all bad, it is best not to dwell on them. They were all bad, until Penny's last surgery. Things got even better this past week. So, now is as good a time as any to ratchet back up the ol' blog.

The below 2 paragraphs will tell the news:

• Penny's cancer was eradicated last June by the removal of part of her left ureter (that ties her left kidney to her bladder). It was found that the cancer was deep in that ureter, and the Urologist was able to remove enough of the ureter to removal all signs of the cancer, but left enough ureter to reattach her left kidney back to her bladder (the worst case scenario was that her bladder, left ureter, and left kidney would be removed... so Penny essentially won the cancer lottery by being able to keep all of her organs). She is technically "in remission" right now and will be getting a Cystoscopy this November or December to see if the surgery's results remain "cancer free". Already, her hair is getting fuller again (now that she is no longer on chemo) and she is looking healthier. God has blessed us incredibly regarding Penny's cancer battle.

• 3 days ago, I was finally approved for a "Service Related Disability Rating" of 50% by the Veterans Administration. They acknowledge that my service medical records and my present medical condition show that I have very serious issues that were caused during my service in the United States Marine Corps. The fact that they acknowledge this 27 years after my release from service is a miracle in of itself (not many people win such battles this far after their service) and I'm not done with that battle either as they are still investigating my other medical issues also and I could be looking at an increase when they are done with their investigation. The fact I had a copy made of my Medical, Dental, and Service records the day before I was released played a huge role in the decision (since they could not find a lot of said records despite our efforts to get a copy of them through the normal channels). Incredibly, 2 months ago - they found the records of my operation in 1983 that had been deemed lost, so we are hopeful more records will be found. So now, I will earn enough to be able to ensure my family stays in our home. A 3 year battle is almost over, Wells Fargo was waiting for this decision and they can now make a decision regarding our loan modification. And I will be having a Social Security (SSDI ALJ hearing on 10/27 which will decide whether I am considered disabled enough for SSDI benefits. So the battle isn't over, but we have won the first round.

So later this week, I will find the time to go over what has transpired over the past year, and I will hopefully be able to articulate what it was like going through this very dark time this past year and what our future holds for us (and a couple of grand babies might be in our future as well).

In the interim, the future is so bright, we've gotta wear shades. =)

James 1:17 "Every good and perfect gift is from above, coming down from the Father of the heavenly lights, who does not change like shifting shadows."

Philippians 4:19 "And my God will meet all your needs according to his glorious riches in Christ Jesus."

Psalm 138:7 "Though I walk in the midst of trouble, you preserve my life; you stretch out your hand against the anger of my foes, with your right hand you save me."

Penny's cancer is back. =( We are now almost 3 years since Penny's Cancer diagnosis.

Penny's cancer is back. =(

Penny and I just received the results of the Operative and Pathology report from last Friday's Cystoscopy (her 13th Cystoscopy since February of 2012). The tumor was at the Bladder Neck (@ the 7 o'clock position) and was 3 cm in size. It was designated: "Papillary urothelial carcinoma, high grade". So it was a fast growing tumor. We will determine the course of treatment with her oncologist / urologist on January 2nd....... (hopefully more Valstar Chemo or BCG). Penny has made it almost 3 years with her bladder intact, and the goal is to continue that effort. She can use a few more prayers in her direction.......

So, what else has occurred in the last 3 months? 

September/October - I was taken to the VA hospital to the Psych Ward for observation. I was released after a week there (a very eye opening experience regarding treatment and the lack of help for other vets who are in more dire need than me). I spent my 23rd wedding anniversary (9/11) in isolation from the world, a very lousy experience. The VA facility is essentially, a dumping ground for some vets who are homeless or who can't take care of themselves and where Navy Recruits who get out due to mental anguish get processed for discharge. The VA staff wanted me to do ECT - Electroshock Treatment and after interviewing me, decided my issues were environmental as a result of stress, not physical like someone with a Bi-polar disorder (I was emphatic I would not do ECT unless it was a last resort). So of course, they put me on Lithium.  36 hours after I got home, I was taken to the ER for a Bleeding Bladder. Unfortunately, when the ER nurse put the catheter in, she tore up my urethra trying to force the catheter upon a path that was not the urethra path (I was in so much pain, I was screaming and Penny was crying while begging them to stop). I spent the next 4 weeks of hell having bleeding incidents (I was hospitalized 4 different times). The urologist then threw up his hands and recommended I go to a hospital downtown. I went to the VA instead, and the Urologist on staff there got things somewhat resolved within 8 days. I no longer use a catheter and a bag (and I'm having no more bleeding incidents).

October - Penny's 81 yr old father fell down at his home and was rushed to the Hospital. After that, it was evident he needed assisted living. Penny and I had 6 weeks to get his mobile home emptied, his cars sold, and get him into an assisted living home. With the help of our Church friends, we were able to get this accomplished (despite the 20 years of old "stuff" we had to pore through). Nobody would let me do anything physical, so I tried keeping things moving regarding projects (not an easy task considering the medications I am on).

November - our 16 year old dog "Maggie" (Border Collie mix) had gotten to the point where she could no longer see, could barely stand, couldn't go down stairs, and was going deaf. Along with Maggie's vet, we decided that we needed to stop her pain as her quality of life was very difficult (so she was put to sleep). Given Penny's attachment to her, I found a way to fill the hole by finding an animal rescue organization who would let us "foster" a dog (which we did at the end of November)... another Border Collie mix (her name is Lolly). The rescue pays for the vet bills and for food, and we provide the home and "care".

December - 2 weeks later, when we went to have her spayed, we were told she was pregnant with 7 puppies. Lolly gave birth less than a week later to 7 puppies (which we are now fostering also - our son is doing a great job of caring for them). Then Penny had her Cystoscopy (and her Cancer had returned). She goes to the Social Security doctor tomorrow (for additional xrays on her knee (that needs replacement). It is simply amazing we have been fighting for her to get Social Security for 9 years........

As of January 1st, we will be officially 4 months behind in our mortgage (this is the only thing we can't afford). Given we are upside down by $100,000 due to the fact the VA will not allow a reduction of the principal, we are looking at foreclosure very soon (and we have run out of options save winning the Lottery). Alas..... the hard part will be to find affordable housing in this area so Travis will continue to be eligible for services here (and can continue to work for Walmart here... where he is accepted and it is close by). Of course, unemployment was never extended by Congress..... but they are willing to fund other pork instead. Oy..... 

So that is the quick breakdown. I am going to try to get back to weekly updates.... as it is cathartic for me to do this once in a while.

Steinar

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May the God of hope fill you with all joy and peace as you trust in him, so that you may overflow with hope by the power of the Holy Spirit.

Romans 15:13 | NIV